EAO video stream

This video presentation showed a case involving multiple gingival recession which was treated with the vestibular incision subperiosteal tunnel access (VISTA) technique. The VISTA technique allowed for coronal advancement of the flap while protecting the soft tissue graft inside the tunnel without papillae reflection. The procedure had the following steps:

• scaling and root planning
• a vertical incision was made and a partial thickness tunnel was elevated. The dissection – always in the same plane – reached the papillae (whose bases must be detached from the inside to permit the whole flap from being coronally displaced)
• root odontoplasty
• double horizontal mattress sutures were anchored coronally with composite
• the graft material was secured inside the tunnel
• vertical incision is sutured

The literature points to a coronally advanced flap (CAF) and connective tissue graft (CTG) as the best combination to obtain root coverage and volumetric tissue gain (both around teeth and implants), but predictable results can also be obtained with the VISTA approach.

“Predictable results can also be obtained with the VISTA approach”

The speaker is currently involved in a longitudinal study to analyse the clinical results of the VISTA technique. The volumetric changes in 2D and 3D are measured by software superimposition of the pre- and post-operative scanned models. The results can be seen in the figures. Some predictive factors were identified: recession class, tooth type, gingival thickness, root prominence, recession depth and recession width.

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